Hypersensitivity

State of altered reactivity in which body react in exaggerated or inappropriate immune

response (IR), one is preceived as a foreign substance (Antigen basically)
Type of hypersensitivity
Immediate hypersensivity/
anaphylatic(Type 1)

Antibody-mediated diseases/
cytotropic (Type II)

Immune complex-mediated
reactions (Type III)

T cell-mediated diseases/
delayed (Type IV)

Pathologic immune
mechanisms
TH2 cells, IgE antibody, mast
cells, eosinophil

Mechanism of tissue injury

and disease
Mast cell-derived mediators
(vasoactive amines, lipid
mediators, cytokines)
Cytokine-mediated
inflammation (eosinophils
& neutrophil)
IgM, IgG antibodies against
Complement- and Fc
cell surface/ ECM antigens
receptor-mediated
recruitment & activation of
leukocytes (neutrophils&
macrophages)
Opsonization &
phagocytosis of cells
Immune complexes of
Complement- and Fc
circulatting antigens &
receptor-mediated
IgM/IgG antibodies deposited
recruitment & activation of
in vascular basement
leukocytes (neutrophils&
membrane
macrophages)
1. CD4+ T cells (cytokinemediated inflammation)
2. CD8+ CTLs (T cellmediated cytolysis)

1. Macrophage activation &

Cytokine-mediated
inflammation (eosinophils
& neutrophil)
2. Direct target cell lysis &
Cytokine-mediated
inflammation (eosinophils
& neutrophil)

Immediate hypersensivity/ Anaphylatic/ Homocytotropic Ab reactions(Type 1)

Stimulated by the binding of IgE to high affinity IgE-specific Fc receptor express on mast
cells & basophils
When cross-linked with antigens, IgE trigger the mast cells & basophi;s to release active
agents (vasoactive amines, lipid mediators, cytokines)
Effect of toxin

Inject a dog with toxin from sea anemonereexpose to the same toxinsuffered
short-like syndrome in minutesanaphylaxis (excessive salivation, defeaction,
difficulty in breathing& paralysisdie

Event in HSTI
1. Sensitization phase
2. Activation phase
3. Effector
Anaphylaxis
1. Generalized
2. Localized : asthma

Antibody-mediated reaction/ Cytotropic (Type II)

Ag + Ab
AgAbCx
Insoluble Ag (bacteria, fungi, parasite) on cell surface.
Event
1. Opsonization (Abs + Ag) ( FcR on phagocytes)
Increase phagocytosis
2. Complement activation C3b
C3b formation of membrane attack complex (MAC)cell lysis
3. NK like cell (ADDC)
Example: AIHA, ITP, Graves disease, Goodpasture syndrome, Streptococcal infection
(rheumatic fever)

Immune complex-mediated reactions (Type III)

Soluble Ag
Ag + Ab
AgAbCx
1. Cx is insoluble : arthus reaction
Ab excess
Allergic & Alveolar pneumonitis
Pigeon fancier disease
2. Cx is soluble : Serum sickness
Systemic Lupus Erythematosus (SLE)
Hepatitis
Malaria

T cell-mediated diseases/ delayed (Type IV)

Exogenous antigen : phagocytosed by APCHLA class IICD4 Th cellsendocytic

pathwayinflammation
Endegenous antigen (in cell): phagocytosed by APCsHLA class I CD8+
CTLscytosolic pathwayapoptosis
Induration
Causes: gold, poison ivy, rubber, nickles, dyes, fragrances etc..
Hapten-carrier system
Examples:
1. Contact dermatitis
2. Tuberculin HS reaction (Mantoux test)
3. Granulomatous HS
4. Leprosy

Non-specific Immunity/ Innate/ Native/

Natural/ Inborn

The early defense against infections

Principal types of reaction : inflammation & antiviral defense
The innate immune system usually responds inthe same way to repeat encounter with a
microbe whereas the adaptive immune system responds more effeciently to each succesive
encounter with a microbe

The innate immune system recognizes that are shared by various classes of microbes:
pathogen-associated molecules patterns (PAMPS)recognize by pattern recognition
receptors.
Portal of entry : skin, eyes, ear, appendages, RT. GIT, UGT
Principles components:
1. In the tissues: detected by macrophages, dendritic cells, other sentinel
cellssecretes cytokinesinflammation
2. In the blood: plasma proteins (complement, Abs)
3. Viruses elicit special reactions, including the production of interferons, type I IFN
from infected cells that inhibit infection of other cells.
4. Killing of infected cells by NK cells.
5. Provide signals to activate B & T lymphocytes.

Transplantation Immunology

Transplatation: replacement of distended organ/ tissue by healthy organs/tissues

Types of graft:
1. Autograft
2. Isograft
3. Allograft
4. Xenograft
General information
1. Major Histocompatibility Complex (MHC): gene complex whose alleles encode
polymorphic cell surface glycoprotein involved in Ag recognition &
presentatiom

2. MHC-matching between transplant donor & recipient reduce risk of rejection/

not taken
Transplantation antigens- one allele inherited from each parent
Class I
Class II
1. Expressed on most
1. Expressed on APCnucleated cellsexogenous Ag
2. Presented Ag to CD4+
endogeneous Ag
2. Presented Ag to CD8+
T cells
3.
HLA-DP,-DQ,-DR
CTLs
4. 9-30 amino acids
3. HLA-A, -B,-C
5. Consists of 2 peptides
4. 8-11 amino acids
5. Consists of one
peptide- B2
microglobulin
HLA encoded by the MHC
Expression of genes is dominant
Multiple alleles of each gene locus

HLA typing
1. Leukocyte agglutination
2. Serology
3. DNA typing-PCR
Uses
1. Transplantation treatment
2. Clinical uses
3. To exclude paternity
4. Anthroplogical studies

Class III
1. Complement
components,
cytokines, enzyme &
shock protein
2. Never in surface
3. In liquid cell form

1. HLA-A* _ _,_ _
Locus * allele group,allele
number
2. HLA-A_
HLA-Cw_
(specificity)
A:28
B: 62
C: 10
DR: 24
DQ: 9
DP: 6
3. DNA typing: SSP, SSOP, RFLP,
SSLP & nucleotide sequencing.

Compilation
1.
2.
3.
4.
5.
6.
7.
8.
9.

Transplantation reaction and relate it with hypersensitivity (essay 2016)

Compare & contrast between HST1 & T2 (essay 2012)
Compare & contrast between serum sickness & arthus reaction (SN 2011)
Hypersensitivity (essay 2009, 2001)
Uses of HLA (SN 2009)
Innate immunity (essay 2008)
Discuss Atopy (essay 2007)
Discuss transplantation (essay 2006)
HLA (essay 2004, 2003,2000)